Confirming Pregnancy After Late Period: What to Expect and Options

Menstruation is more than a week late, and pregnancy has been confirmed with two different brands of pregnancy tests?

The first day of my girlfriend's last menstrual period was October 4th, with an average cycle length of about 30 days.
There was one instance of unprotected intercourse on October 23rd, after which she took emergency contraception (Plan B) within 5 hours.
On the morning of November 12th, two different brands of pregnancy tests both showed two lines, indicating a likely pregnancy.
Additionally, she started experiencing abdominal pain in early November, initially thinking it was due to an impending period, but it has not arrived yet.
Is there a possibility of an ectopic pregnancy? My girlfriend is 20 years old and unmarried, and we have discussed that we are both young and want to terminate the pregnancy.
Given this situation, how many weeks pregnant might she be (considering there was only that one instance of intercourse after her last period)? Which method is more advisable at this stage: medical abortion or surgical abortion? What are the costs associated with each? My girlfriend is very worried about her family finding out and insists that they cannot know.
She will be visiting an obstetrician-gynecologist today for an examination and to arrange for follow-up care.

Lan Tu, 10~19 year old female. Ask Date: 2015/11/13

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
Based on the estimated time of conception, it is approximately five weeks.

2.
An ultrasound can be performed to visualize the implantation site of the embryo, which helps determine whether it is a normal intrauterine pregnancy or an ectopic pregnancy.
(If the abdominal ultrasound does not provide clear images, a transvaginal ultrasound can be conducted.)
3.
Both medical abortion and surgical abortion have their drawbacks.
Medical abortion may result in prolonged bleeding and occasionally incomplete expulsion, which can cause abdominal pain during the process.
Surgical abortion carries a higher risk of complications such as uterine inflammation or injury.

Respectfully, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/11/13

More Info

Based on the information provided, your girlfriend's last menstrual period began on October 4, and she had unprotected intercourse on October 23, followed by taking emergency contraception (Plan B) within five hours. The positive pregnancy tests on November 12 indicate that she is likely pregnant. Given her average cycle length of about 30 days, ovulation would typically occur around October 18-19, making the timing of the intercourse on October 23 plausible for conception.

Understanding the Situation
1. Pregnancy Confirmation: The two positive lines on the pregnancy tests suggest that she is indeed pregnant. Home pregnancy tests are generally reliable, especially when taken after a missed period.
2. Timing of Pregnancy: If we consider the date of her last menstrual period (October 4) and the typical gestational age calculation, she would be approximately 6 weeks pregnant at the time of the positive test on November 12. This is calculated by counting from the first day of her last menstrual period, which is the standard method for estimating gestational age.

3. Symptoms: The abdominal pain she experienced could be due to various reasons, including normal early pregnancy symptoms, but it is also important to consider the possibility of an ectopic pregnancy, especially if the pain is severe or accompanied by other symptoms like bleeding. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in a fallopian tube, and can be a serious condition requiring immediate medical attention.

Options for Termination
Given that you both have discussed the option of terminating the pregnancy, there are two primary methods to consider:
1. Medical Abortion (Medication Abortion): This method involves taking medication to induce a miscarriage. It is typically recommended for pregnancies up to 10 weeks gestation. The process usually involves taking two different medications: mifepristone followed by misoprostol. The effectiveness is high, and it can be done in the privacy of your home. The cost can vary widely depending on the provider and location, but it generally ranges from $300 to $800.

2. Surgical Abortion: This method involves a minor surgical procedure to remove the pregnancy from the uterus. It can be performed in a clinic or hospital setting and is usually done under local anesthesia or sedation. Surgical abortion can be performed up to 24 weeks, but the earlier it is done, the simpler the procedure. The cost for surgical abortion can also vary, typically ranging from $500 to $3,000, depending on the gestational age and the facility.

Next Steps
- Consultation: It is crucial for your girlfriend to visit a healthcare provider, as she has planned. They will perform an ultrasound to confirm the location of the pregnancy and assess her overall health. This will help rule out ectopic pregnancy and determine the gestational age more accurately.

- Discuss Options: During the appointment, she should discuss her options for termination, including both medical and surgical methods, and any concerns she may have regarding privacy and support.

- Emotional Support: This can be a challenging time emotionally. It may be beneficial for both of you to seek counseling or support groups to help navigate the feelings and decisions involved.

Conclusion
In summary, your girlfriend is likely around 6 weeks pregnant based on the information provided. It is essential to confirm the pregnancy's location and health with a healthcare provider, especially considering the symptoms she has experienced. Both medical and surgical options for termination are available, and the choice should be made based on her health, gestational age, and personal preferences. It is important to ensure she feels supported and informed throughout this process.

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